CN107468415A - For treating the method and apparatus of gland dysfunction - Google Patents
For treating the method and apparatus of gland dysfunction Download PDFInfo
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- CN107468415A CN107468415A CN201710219080.3A CN201710219080A CN107468415A CN 107468415 A CN107468415 A CN 107468415A CN 201710219080 A CN201710219080 A CN 201710219080A CN 107468415 A CN107468415 A CN 107468415A
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- Prior art keywords
- meibomian gland
- obturator
- eyelid
- gland
- meibomian
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F9/00—Methods or devices for treatment of the eyes; Devices for putting-in contact lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
- A61F9/007—Methods or devices for eye surgery
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F7/00—Heating or cooling appliances for medical or therapeutic treatment of the human body
- A61F7/007—Heating or cooling appliances for medical or therapeutic treatment of the human body characterised by electric heating
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F7/00—Heating or cooling appliances for medical or therapeutic treatment of the human body
- A61F7/02—Compresses or poultices for effecting heating or cooling
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N5/00—Radiation therapy
- A61N5/06—Radiation therapy using light
- A61N5/0613—Apparatus adapted for a specific treatment
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N5/00—Radiation therapy
- A61N5/06—Radiation therapy using light
- A61N5/067—Radiation therapy using light using laser light
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F7/00—Heating or cooling appliances for medical or therapeutic treatment of the human body
- A61F2007/0001—Body part
- A61F2007/0002—Head or parts thereof
- A61F2007/0004—Eyes or part of the face surrounding the eyes
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N7/00—Ultrasound therapy
- A61N2007/0043—Ultrasound therapy intra-cavitary
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N7/00—Ultrasound therapy
Abstract
It is a kind of to flow and be used for the method and apparatus for treating the gland dysfunction as caused by blocking body of gland, including applied energy, suction, vibration, temperature, sucking-off, the combination of chemical agent and medicine naturally from body of gland so that obturator is loosened and then removes it to recover secretion.
Description
The application is the applying date for August in 2006 21 days, China national Application No. 201210127347.3, denomination of invention
For the divisional application of the patent application of " being used for the method and apparatus for treating gland dysfunction ".
Invention field
The present invention relates generally to treatment body of gland so that the Meibomian gland recovery of the body of gland and particularly eye blocked in vivo is natural
The field of secreting function.
Background of invention
Human body contains on many bodies of gland, including the lachrymal gland of eye and Meibomian gland, face and oxter sebaceous glands or hair-sebum
Mammary gland in hair gland and breast.Because age, stimulation, environmental aspect, cell fragment, inflammation, hormone imbalances and others are former
Dysfunction can occur for cause, these bodies of gland.A kind of common dysfunction is the natural restricted in flow for the secretion for flowing out body of gland
Or interrupt.
Although following description is related to the Meibomian gland of eye, it is understood that, the present invention can be used for treating all bodies
The exocrine gland of body.For specifically referring to human eye, the tear film of ocular is covered by up of three layers.The innermost layer contacted with ocular is
Rete malpighii.It is water-bearing layer to form tear film most intermediate layer, and outermost layer be by many be known as " eyelid fat (meibum) " or
Thin (the being less than 250nm) layer of the lipid composition of " sebum ".Sebum by the expansion in upper palpebra inferior specialized sebaceous-type gland
Body (therefore, using " sebum " to describe the secretion) Meibomian gland secretion, by specially making lipid secretions flow to the hole of margo palpebrae, so as to
Form the lipid layer of tear film.Typical upper eyelid has about 25 Meibomian glands, and palpebra inferior has than the tarsus positioned at upper eyelid
About 20 slightly larger Meibomian glands of gland.Meibomian gland includes the more seed capsules sample acinuses for the pipeline that secretion is flowed into body of gland.Then secrete
Thing passes through by estimating the smooth muscle tissue to be helped out in sebum is discharged and the circular hole of Li Ao Lang Shi (Riolan) flesh.Eyelid
Plate gland orifices open is in the margo palpebrae generally along the mucocutaneous connection for also being known as gray line (gray line).It is assumed that Meibomian gland
Hole is as blink is opened and is discharged in sebum secretion thing to the margo palpebrae of small quantity, subsequently into lower section cus lacrimalis (tear
meniscus).Lipid " sebum " in cus lacrimalis is applied upwards by upward blink action opens up and covers the tear film widened the view.If fat
Matter secretion is in optimum state, then enough lipid layers maintain Air Interface and reduce evaporation with minimally and prevent from doing
Eye state.If lipid secretions are insufficient, lipid layer is not enough to minimally reduction and evaporated, and the result of rapid evaporation
Cause dry eye states.Therefore, it should be observed that, lipid layer, which lacks, or the amount or matter of such lipid are incorrect causes adding for water layer
Speed evaporation, then causes the symptom that may include the hereinafter collectively referred to as symptom of " dry eyes ", such as dries, abrades, stimulation, calcination,
Shed tears, see red and itch.
Dry eye states have many causes of disease.The common cause of common dry eye states is the disease of referred to as " meibomian gland dysfunction "
The obstacle that disease, wherein body of gland are blocked or occlusion forms.As used in this article, term " occlusion " and " obstruction ", when them
When being related to meibomian gland dysfunction, it is defined as partially or completely obstruction or the blocking of Meibomian gland.If obstruction completely, body of gland
It can not secrete.If partially or intermittently inaccessible, body of gland either normal secretions or sebum secretion amount can be reduced.More usually
It is that secretion is changed to have semi-solid, stiff, condensation secretion, is frequently described as the secretion of concentration.
Secretion can be clarification or slightly yellow, and the latter refers to possible infection, belephroadenitis, a kind of inflammation for causing meibomian gland dysfunction
Disease, generally along with blepharitis (inflammation of eyelid).Meibomian gland dysfunction can be with belephroadenitis, or Meibomian gland work(may be present
Energy obstacle is without obvious lid inflammation.Meibomian gland dysfunction often makes the single of single Meibomian gland secretion function involvement
The result of meibomian gland orifices and/or body of gland mesotube (conduit) keratotic obstructions.More specifically, these keratotic obstructions include
Exfoliative cells, keratin, sebum matrix and the combination of bacterium, referring to Korb etc., meibomian gland dysfunction and contact lenses
(Meibomian Gland Dysfunction and Contact Lens Intolerance), ophthalmology association magazine are not tolerated
(Journal of the Optometric Association) volume 51, the 3rd phase, (1980), the 243-251 pages.Passing through
When inspecting outer eyelid and substantially finding belephroadenitis, meibomian gland dysfunction can unobvious, even the slit-lamp with enlargement ratio
It is also in this way, because can not have an Exterior Sign during biomiocroscopy, or Exterior Sign can be small to being not taken care.Eyelid
The Exterior Sign of the dysfunction of plate gland can be limited to the slight change of meibomian gland orifices, epithelial cell it is trickle on aperture or
Obvious undue growth and cause aperture diminish (pouting) epithelial cell undue growth under, to be used as the solidifying of obturator
Knot material makes the aperture of body of gland diminish.
The Hormone change in climacteric, and the particularly change of estrogen level are betided including those, can be caused due to gland
The obstruction of body opening and by Meibomian gland secretion oiliness secretion thicken.Further, the reduction of estrogen level can also make staphylococcus
Fertile condition enhancing.This can cause bacterium to travel to body of gland, so as to cause secreting rate to decline.
When the presence due to obturator makes the restricted in flow of the secretion from Meibomian gland, the epithelium on margo palpebrae is thin
Born of the same parents tend to cover with gland orifice, therefore also limit sebum flow and deteriorate dry eye condition.
Other factors that meibomian gland dysfunction can be caused or deteriorate meibomian gland dysfunction include age, implicit type eye
Mirror abrasion and hygienic issues, blink obstacle, long-term use of computer, use cosmetics or Other diseases, particularly diabetes.
The clinical assessment of Meibomian gland need on Meibomian gland eyelid outer surface apply pressure, with determine secretion whether be
Obtained under gentle pressure by single body of gland.If gentle pressure does not provide secretion, using extrude at full tilt with
Determine whether to can obtain secretion.Therefore, the state of single Meibomian gland (wherein can extrude clarification optimal with gentle pressure
Meibomian sebum) state, (wherein obtain milky fluid or dense or creamy secretion to light or moderate meibomian gland dysfunction
Thing)；To total blockage (even if wherein applying great pressure, any kind of secretion is not obtained yet (see Korb etc., " treatment
Increase Tear Film Lipid Layer Thickness (Increase in Tear Film Lipid Layer after meibomian gland dysfunction
Thickness Following Treatment of Meibomian Gland Dysfunction ", lachrymal gland body of gland, tear film and
Dry eye syndrome (Lacrimal Gland, Tear Film, and Dry Eye Syndromes), the 293-298 pages,
D.A.Sullivan writes, Plenum publishing houses, New York (1994)).The significant chemical change and tarsus of meibomian gland secretions
Gland dysfunction produces together, so as to which naturally-produced tear film composition produces change, and it transfers to occur to be commonly referred to as " dry eyes "
Ophthalmology disease.
When tear film is run as single entities and its all layer is important, from the lipid layer of Meibomian gland secretion
With especially important meaning, because its function is to slow down the evaporation of lower floor and lubricate eyelid in blink to prevent dry eyes.
According to foregoing teachings, a variety of therapeutic modalities have been developed to treat dry eye condition, including are intended to replicate and substitute day
The eye drops of right tear film, it is intended to stimulate body of gland and cell to provide the medicine of tear film composition and be designed to treat belephroadenitis and place
Manage a variety of hot compresses and the warmer of Meibomian gland.
Eye drops, such asWithBoard eye drops is designed to close to duplication day
Healthy tear film caused by so.However, their application and administration only symptomatic treatment rather than for the potential cause of disease.Again
Have, the use of eye drops is generally used for uncertain time span, so as to which long-term use can become trouble and costliness.
Also suggestion uses medicament forms, such as tetracycline treatment meibomian gland dysfunction, and a kind of such treatment
In the U.S. Patent Publication number US2003/ for entitled " method for the treatment of meibomian gland disease " for being issued to Pflugfelder etc.
The U.S. Patent number 6,455,583 of the 011426th, entitled " method for the treatment of meibomian gland disease " and entitled " tetracycline treatment Meibomian gland
Disclosed in the PCT Publication WO 99/58131 of the application of disease ".However, the treatment is not proved to be to face for obstruction of tarsal glands
Bed is effective, and its can be in the case of many meibomian gland dysfunctions as caused by body of gland obturator when without infection need not
Want.Such as be issued to Pflugfelder it is entitled " corticosteroid of part preservative free be used for dry eyes, thread angle
The U.S. Patent number 6 of the scorching treatment that (or circulation) is removed with delay tear of film ", disclosed in 153607, corticosteroid steroid
Use be also proposed treat meibomian gland dysfunction.In addition, the treatment that this proposes seems to treat the symptom of dry eyes, without controlling
The potential cause of disease is treated, and the risk for producing cataract and glaucoma also be present.Further, such as entitled " should in keratoconjunctivitis
With the androgen or the ophtalmic treatments of TGF-β locally used " U.S. Patent number 5,958,912 and U.S. Patent number 6,107,
Disclosed in both 289, have also been used to using the androgen or androgen analog that locally use in keratoconjunctivitis
Middle treatment acute dry eye signs and symptom, two patents are issued to Sullivan.
" it is used for the chemical method that includes of temperature adjustment entitled for treating another form of meibomian gland dysfunction
Disclosed in the european patent application sequence number PCT/GB2003/004782 of eyelid ".As disclosed in this patent application
, there is provided a kind of eyelid, wherein before use, the change that activation will make the wiper be heated to 32 DEG C to about 55 DEG C
Reagent is learned, and wherein maintains treat margo palpebrae within least 10 minutes the temperature.This method is not without its shortcoming, wherein
Nonspecific temperature can make eyelid stimulate exacerbation, and specified as comfortable heating range will burn when more than 50 DEG C
Skin.Another method for heating eyelid and Meibomian gland is to use near infrared ray.More particularly, the pupil according to subject
Two pieces of hard eye sticker pieces are attached on eyeshade away from size.Eyeshade is secured in place by elastic head band.Each patch
Piece is the light emitting diode of 940nm near infrared ray using 19 transmitting 850nm-1050nm, peak value.The device is after powered up
Produce 10mW/cm2Energy.Goto, E. etc., by infrared hot compress (Infrared Warm Compression) device to non-
The treatment of inflammatory obstructive meibomian gland dysfunction, Britain's ophthalmology magazine (British Journal of
Ophthalmology), volume 86 (2002), the 1403-1407 pages.
The U.S. Patent Publication number US2004/0237969 of entitled " Therapeutic Eye and eyelid cover " covers a pair and is suitable to
The goggles of wet saturated air is transmitted to surrounding eyelids.The form of therapy is also being published in ophthalmology by Mitra etc., (2004) 1-
In page 4 it is entitled " normal subjects via new device latent heat to tarsus treat after Tear Film Lipid Layer Thickness and eyes
Discussed in more detail in the article of comfort level ".
The U.S. Patent Publication number US2003/ of Yee entitled " being used for the method and apparatus for preventing and treating eyelid disease "
0233135 attempts using electro photoluminescence current invention assumes that to extruding helpful inner Lang Shi (Riolan) flesh difficult to understand of meibomian gland secretions
The Meibomian gland of method cleaning occlusion.
It is to be understood that above-mentioned all form of therapy are not without the shortcomings that its is intrinsic and defect.For example,
The application of the existing treatment to Meibomian gland heating is very time-consuming.Generally, treatment includes applying temperature at least 15 minutes, with defensive position
Dynamic extruding, its generally as after the part including the eyelid where placing cotton swab or surface being fixed on into the Meibomian gland of obstruction and from
Body of gland extrudes obturator manually, although using the local anaesthetics provided by eye drop form, the former often very pain.
Therefore, it is an object of the present invention to provide the shortcomings that overcoming first technology and defect meibomian gland treatment.
It is a further object of the invention to provide the meibomian gland treatment device treated with one step, therefore, eliminates hand
The needs of dynamic extruding.
The present invention's a further object is, there is provided treats meibomian gland disease and is not only to treat the meibomian gland treatment of its symptom
Device.
It is a further object of the invention to provide recover natural sebum flow rather than merely attempt to substitute or replicates naturally
The meibomian gland treatment device of caused tear component.
A further object of the present invention, which is to provide, makes the chance of infection reduce to minimum meibomian gland treatment device.
The further purpose of the present invention is to provide simple, cheap and is easy to as healthcare provider and trouble
The meibomian gland treatment device that person uses.
Invention summary
According to the present invention, provided herein is for treating the method and apparatus of meibomian gland dysfunction, wherein making to come from tarsus
The flowing of the naturally-produced secretion of gland recovers.This method is included to recover the natural stream of the secretion from Meibomian gland
It is dynamic, apply adjusted power, adjusted energy, adjusted temperature and/or chemical agent/medicine or its combination to eyelid, with
Remove obstruction.In another aspect of the present invention, obturator can be dissolved, from gland walls obstructions thing and/or makes obturator
Loosen, soften obturator before suction and/or gland orifice or channel expansion, so, recover the normal secretions from body of gland.At this
The other side of invention, obturator can be loosened from gland walls or soften obturator before suction.Furthermore apply with
Loosen obturator power can have pre-selection size and apply the period of pre-selection.
The apparatus include to body of gland apply external force or internal force, energy or temperature (or foregoing combination) with loosen obstruction
The instrument of thing.More aspects of the present invention, which include providing, is used to making before suction obturator softening, broken and/or liquefied work
Tool and the instrument for extracting obturator.
The summary of figure
Fig. 1 is the diagrammatic cross-section of the upper and lower eyelid of the Meibomian gland illustrated with section.
Fig. 2 is the cross section view of single Meibomian gland.
Fig. 3 a are the stereograms for clearing up the system of the Meibomian gland of obstruction.
Fig. 3 b are the cutaway side sectional views for the tips of probes of Fig. 3 a embodiment.
Fig. 4 a are the stereograms according to second of embodiment of the tips of probes of the present invention.
Fig. 4 b are the cutaway side sectional views of Fig. 4 a tips of probes.
Fig. 4 c are placed in the cutaway side sectional view of superciliary Fig. 3 a and 4a tips of probes.
Fig. 5 is the cutaway side sectional view of the alternative of the Meibomian gland of the cleaning obstruction according to the present invention.
Fig. 6 a are one of tips of probes Meibomian gland, having roller for being used to clear up obstruction according to the present invention alternative
The side view of embodiment.
Fig. 6 b be tips of probes Meibomian gland, that there is roller for being used to clear up obstruction according to the present invention another is standby
Select the side view of embodiment.
Fig. 7 be tips of probes Meibomian gland, that there is roller for being used to clear up obstruction according to the present invention another is standby
Select the side view of embodiment.
Fig. 8 is the stereogram for being used to clear up the aspirator of body of gland according to the present invention.
Fig. 9 is the side view for being used to clear up another embodiment of the apparatus of Meibomian gland according to the present invention.
Figure 10 a are the schematic diagrames for being used to clear up another embodiment of the apparatus of Meibomian gland according to the present invention.
Figure 10 b are the exploded views of the handheld probe of Figure 10 a embodiments.
Figure 10 c are the side views of Figure 10 a and 10b handheld probes to eyelid applying power.
Figure 11 a are the meibomian gland treatment apparatus of hydro-oculator (hydro-oculator) form for being in the foundation present invention
The stereogram of another embodiment.
Figure 11 b are the side views of Figure 11 a hydro-oculator.
Figure 11 c are placed in the diagrammatic side view of the hydro-oculator of the foundation present invention against palpebra inferior.
Figure 11 d are placed in against palpebra inferior and show that the pouch of fluid filling starts expansion, the foundation present invention water
Treat the diagrammatic side view of goggles.
Figure 11 e are placed in against palpebra inferior and show that the pouch of fluid filling is in further swelling state, foundation
The diagrammatic side view of the hydro-oculator of the present invention.
The detailed description of preferred embodiment
Although the present invention will be described more fully below, this hair is still realized although should be understood that when starting
Bright favourable result, professional and technical personnel in the field can change invention described herein.Therefore, following description will be managed
The religious doctrine solved as the broad sense for appropriate skilled artisan discloses and is not understood to limitation of the present invention.
Referring now to Figure 1, Meibomian gland M position is shown on palpebra inferior.As briefly stated herein above, upper eyelid contains
There are about 25 Meibomian glands and palpebra inferior contains about 20 Meibomian glands.As shown in Figure 2, it is therein that each body of gland includes secretion inflow
Channel C and the hole O for being opened to margo palpebrae, and by this hole, to make secretion to flow to be added in tear film in blink.
, it is seen that the position in the eyelid of place is different, body of gland has different sizes, and hole O is narrower than channel C.
As briefly mentioned herein above, obturator composition is different and different according to its teiology is produced.However, most of
In the case of, obturator by by dead cell, keratin, bacterium, cast-off cells, sebaceous ground substance, milky fluid, concentration or it is newborn
The secretion combination of smectic, or aforementioned substances are formed with any combinations of solid, semisolid and thickened forms.Obturator may be present
In gland channel, in gland orifice, in gland orifice or foregoing combination.As used herein, obturator refers to foregoing any
One of.
Therefore, it is self-evident that, any obstruction of passage will be restricted or prevented secretion and be discharged from body of gland, also, more
Have notably, in order to clear up such obturator or " tamper ", obturator can be made to loosen from gland walls, and/or make it
Broken, fracture, softening or liquefaction, so, it can fit through gland orifice without causing extra pain.Finally, it is necessary to will hinder
Plug thing residual is extruded from body of gland.The method provided by the present invention and apparatus are to realize these tasks.
Method according to the present invention, it should be allowed to soften or liquefy before attempting to aspirate or extruding obturator P.As for preceding
Content is stated, term " softening " or " liquefaction " are intended to refer to the flowable state of " non-solid ".In addition, in order to be clinically satisfactory,
Obturator P softening or liquefaction should be realized effectively as quickly as possible, and adjusted heat treatment time should be less than five (5)
Minute, and do not cause eyeball or eye circumference to enclose one to two (1-2) minute of tissue injury be preferable, such heat treatment can be
Electricity, laser heating, hot water conductive's heating, infrared heating, ultrasonic Wave heating, RF heating etc..This must can require ratio by hot compress
The energy (heating) of the conventional transferable more additional quantities of application, the hot compress attempt to remove according to current practice in doctor
3-15 minutes are applied before obturator.Once softening or liquefying obturator, can remove by applying adjusted power to body of gland
Obturator.More particularly, expected the applied power of the present invention is the power of the control repeated, such as that more fully explained below
Sample.
The processing of obturator is removed by including to eyelid and/or directly applying adjusted external force on the hole of obstruction, with
The obturator in body of gland G and hole is set to loosen.Instrument for applying power may be selected from the one or more in various ways, the side
Vibration frequency in formula may include low frequency vibration (being generally less than 1000Hz), sound wave (general 1000Hz to 20,000Hz) or super
Acoustic wave energy (generally higher than 20,000Hz), liquid stream injection, such as air or water, microwave energy, syringe needle, micro needle head, laser
Energy, RF energy, sucking-off/suction, vacuum, pressure, extruding and its function equivalent.In addition, once select certain mode, doctor
It will have to determine optimum processing parameter, so, each foregoing mode will be applied in eyelid, so, thus provide
Power (or energy, in due course) passes to obturator by eyelid tissue.Further, processing intensity and these external force are using duration
It will change according to the size of obturator and composition.Once establishing therapeutic scheme, the power can either be set or the scope in pre-selection
Interior change.Tested using bias (eccentric) vibrating motor for being directly applied to people's eyelid.The engine bench test of vibration is taken off
Show data below point, display is clinical effective to the obturator in loosen Meibomian gland and hole particularly when setting numerical value 3：
Once obturator loosens from gland walls, even can be by causing patient few when it will be by hole O
There is no pain or the mode of discomfort to handle it.This can be by being heated to 37 degrees Celsius (37 DEG C) to 50 degree Celsius (50 by obturator
DEG C) be accomplished with the obturator that softens or liquefy, preferable 40 degrees Celsius of practical range (40 DEG C) to 47 degrees Celsius (47 DEG C), and
The mode needed is 42 degrees Celsius (42 DEG C) to 46 degrees Celsius (46 DEG C), and so, obturator is easy to (or with it to the greatest extent may be used by the hole
Non- pain expansion that can be small is together).Mode (Modalities) for heating may include by following provided one kind or more
Conduction, convection current and the radiation of various ways：Heat transfer, thermal convection current, ultrasonic energy, laser energy, RF energy, from available for pre-
The thermal source of the microwave energy of period is selected directly and/or indirectly to transmit.By the amplitude of change application, intensity and length, also may be used
Obturator is fractured or break up using foregoing some modes.It should be understood that during heating, this can used at eyelid
Closed loop feedback control system (not shown) detection temperature known to art personnel, to ensure that obturator actually reaches foot
So that obturator is changed into flowable, liquid or the temperature of semi liquid state.
Can in the following manner in one or more, complete softening, broken apart or fracture obturator takes out
Inhale：Syringe needle, micro needle head, sucking-off/suction, vacuum, pressure and extruding.One embodiment of the invention be placed in gland orifice it
On suction system can be used for suctioning out softening, loosening or liquefied obturator composition or its fragment, appropriate or optional
Ground is selected, for aspirating with the obturator of collection discharge gland orifice.For Clinical efficacy, it should in a manner of adjusted, i.e., with
Repeatable mode is implemented to be previously used for extracting or extrude the mode of obturator.
Schematically illustrated in fig. 3 a for the gland channel C for the making obstruction apparatuses dredged.The apparatus is included when needed
It can be the power supply 100 of direct current (battery powered) or alternating current (power outlet on wall).Power supply 100 can be included with referring generally to
The 200 controller connection of power switch 210.Controller 200 includes being used to apply external force to body of gland with the work for obturator of loosening
Tool 220.The instrument 220 includes being suitable to the probe 230 of the amplitude vibration with the frequency of pre-selection, pre-selection.Probe 230 can be when needed
Vibrated with sonic frequency or ultrasonic frequency.Additionally, it is provided the frequency for changing probe output familiar to the person skilled in the art
The instrument of rate 240 and amplitude 250.Instrument 220 for applying adjusted external force or from adjusted energy to obturator also may be used
It is current, microwave energy, syringe needle, micro needle head, laser energy, RF energy, sucking-off, suction, true including liquid stream injection, air stream
Sky, pressure, piezoelectricity and extruding.
Turning now to Fig. 3 B, small ultrasonic probe 230 (and particularly tips of probes) is being schemed in the appropriate location of eyelid
Illustrate in 4C.In order that obturator is loosened, liquefies and/or is broken, probe 230 fits through skin transport ultrasonic vibratory energy
Into obturator P.More particularly, exported by adjusting probe, so that obturator P resonance (by the frequency of Regulate signal and is shaken
Width), energy efficient is transferred to obturator and triggers obturator P resonance and makes the energy transmission to surrounding tissue minimum.
In some cases, individually vibration can be enough the characteristic for changing obturator P, the remnants of the so strong extrudable obstruction of blink
Thing.
In addition to vibration alternately power (alternative force), energy, sucking-off and/or chemical agent/medicine also can be used
Open channel C.Probe can also be provided with sucking-off instrument 260 and (import gland channel C for that will suction out, and aspirate or be sucked by vacuum to take out
Go out the residue of obstruction, most preferably illustrated in Fig. 4 C.Or temperature can be used and suction out and substitute vibration or also using vibration.
In the present invention on the other hand, probe 230 can match somebody with somebody the instrument 270 of heating of being ready for use on, solid-state that such as can be adjusted
Heating element heater, to provide the energy of the relatively precise amount in aforementioned range, to pass through tissue when probe is placed in into tissue
Temperature transmission help soften, liquefy or melt obturator P.
Second embodiment (Fig. 5) of the present invention is stripped off using crystallite skin care art (microdermabraision) or micro- mill
Dead skin method (exfoliation) can cover with any cell or cellular material of gland mouth to remove.Crystallite skin care art is exploitation
For dermatology to remove the method for dead skin cells.As shown in fig 5 a, probe or top 330 are equipped with suitable for scraping
The lapped face 310 of skin.Used abrasive is typically that Buddha's warrior attendant husky (diamond power) or those skilled in the art are ripe
The other appropriate materials known.Inner tube 320 with medium pore 325 includes being defined as aspirating the opening of fluid such as air by it
330 hole.Outer cover 335 is looped around around pipe 320, but and and lapped face somewhat lower in its relatively low edge swell
310 to separate one intersegmental every the interval is limited at the space between the relatively low edge of each pipe 320,335.Outer cover with as below
Sucking-off, vacuum suction and/or the suction association of the implementation of description.
In operation, grinding top 310 should be placed on gland orifice and contact place by clinician, make top and skin
Sealed between skin.The motion of probe 330 will cause the abradant surface 310 of headstage ground so that cell separates with skin, and suctions out, takes out
Inhale or be sucked by vacuum with from neighbouring gland mouth suction of cells material.In addition, by obturator, individually suction out, suction and/or
Vacuum suction can be enough obstructions thing.
Also it can provide microdermabraision tip extra characteristic, can such as be placed in outer cover 335 close to the heating element heater on top
340.In addition, inner tube 320 can be equipped with, so, as discussed above, can be by transfer of ultrasonic energy to obturator.
Another embodiment of the invention can be used chemical agent cleaning gland margin and remove cell from meibomian gland orifices or make
Cell pellets come off.For example, it can be usedOr similar medicine helps to remove epithelial cell on gland orifice.
It can be used and be similar to probe shown in Figure 5, but unlike, inner tube will use the suction transmitted chemical agent and applied by outer cover
Discharged in by chemical agent and cellular material mixture from gland margin.Similarly, heating and vibration discussed above be may also comprise
Characteristic.
Another embodiment of the invention can not contact body of gland and transmit vibration and/or heat energy to obturator P.One kind is latent
The energy be by titanium, argon, krypton or microwave energy provide laser.The suction of obturator will be completed by mean described herein above.
The 3rd embodiment of the present invention use by be placed in it is before or after Meibomian gland, be shown in Fig. 6 a, 6b and 7 roller
Sub (or rotary drum) 375 puts on the pressure of tissue, and the roller applies adjusted constant pressure to apply " milking " sample to Meibomian gland
Power discharges obturator, body of gland is recovered to normal secretion levels.Roller can with it is described herein heating, suction out, vacuum suction
And/or suction is associated.
In force, doctor roller 375 should be placed in eyelid contact position, either in eyelid or outside eyelid
Or both.The flank movement of roller 375 will produce pressure, put on body of gland to remove obturator.Or it can apply and inhale
Go out, aspirate and/or be sucked by vacuum with from the proximity obstructions thing and material of gland mouth.In addition, according to obturator, individually
Suction out, suction and/or vacuum suction can be enough obstructions thing.
Also the extra characteristic of roller, all being placed in outer cover close to the adjusted of top as shown in Fig. 6 A are provided to
Heating element heater (not shown).In addition, roller 375 can be equipped with, so, as discussed above, can be by transfer of ultrasonic energy to resistance
Plug thing.
Fig. 8 illustrates the prototype hand held suction system generally pointed out in 400 constructions.The system includes giving connecting pipe system
The AC power supply 410 that 430 suction pump 420 is powered.In the opposing end portions linking probe 440 of pipe-line system 430.Have
The end of 1mm diameters and the linking probe 440 of top 450 of 200 micron openings.Probe end 460 is set to be bent to conform to ergonomic
Learn (ergonomic) and lead to gland orifice.In use, top 450 is placed in gland orifice or at gland orifice, applied
Vacuum be used to collect obturator in obturator tap, or alternatively, vacuum can be used for assisting in extruding obturator.
Fig. 9 illustrates another prototype hand held suction system generally pointed out in 500 constructions.The system includes can be easy to installation
The power supply unit 510 of electromagnet (not shown) power supply in the handle 530 being hold by one hand by doctor.Mounting rod 540 is suitable to
Move back and forth so that electromagnetism exports.The total amount that pushes or move of bar 540 is 0.5mm.The end of bar 540 is mounted in and is basically perpendicular to bar
On the backboard 550 of 540 axles.In addition, control-rod 560 through being pivotally mounted on bar 540 and operating to start roller 570.Heating
Instrument or heater 580 are mounted in backboard 550.It is also provided with the heater 580 of appropriate power supply.In operation, the dress is placed
Put, so as to which backboard 550 is placed between cornea and the back surface of eyelid.Control-rod 560 is started, so that roller 570 contacts eye
The preceding surface of eyelid.The radian of roller eyelid can be squeezed in it is above-mentioned between.Clinician may be selected to keep backboard and make roller
Son is in tension, and the period for pre-selection is so that what obturator softened.Once having reached the temperature of needs, then apply pressure
Power on control-rod 560 in will be such that roller is moved to from the bottom of Meibomian gland (end away from hole) at the top of body of gland, with " milking type "
Motion extrudes obturator from body of gland.Therefore it provides the repeatable adjusted method of the Meibomian gland for opening obstruction.
In Figure 10 A until in the embodiment that 10C illustrates, prototype of the present invention is generally in 600 hand-held apparatus pointed out.Should
It can be dc source, such as battery or the power supply 610 similar to those AC power supplies being discussed above that apparatus, which includes,.Power supply 610
In shell 620.Power supply 610 provides current to ripple from generator 625, to audifier 630 (for example, Mini-type audio equipment is raised
Sound device) generator that provides power also is located in shell 620 and to meet the installation of the angle of ergonomics there.Sound equipment
The programmed wave format with 0.25mm to 5mm scopes amplitude, 0 to 200Hz frequency of amplifier 630 is vibrated.Initial
Experiment is pointed out, is resistant to very well with 60Hz to 125Hz frequency, 3-4mm free air amplitude, and should in the 10-30 seconds
With rear, it appears that give the sensation of natural numbness to eyelid/body of gland.Above operative association atop, audifier 630
The floating taper outer cover 640 for having annulation 635 and including away from amplifier 625, parcel amplifier 625 vertical expansion.Outside
The end of cover 640 is suitable to install a variety of tops 650.For example, top may include that installation is used to rotate in bracket (cradle) 665
Roller 655.In addition, top 650 can be improved with the adjusted heating element heater (not shown) including playing softening obturator.
Other tip configurations may include the vacuum absorber for collecting obturator after being discharged from body of gland, and different tip configurations should
For a variety of contact surfaces and produce power.Therefore, it should be observed that, obturator is actually subjected to the effect of a pair of power, and the first is in gland
The gravity of device itself on body, its extra pressure that can be pressed in health care worker on body of gland are added by top 650
Caused vibration or pulsating force pass to the additional intermittent joint of body of gland.The first power can continue ceaselessly to apply for fixed
Power or increase to the maximum amount of power of pre-selection.Test applies the first power it has already been indicated that using preceding method to Meibomian gland
With second of pulsating force so that transmit larger amount of energy to obturator and reduce the level of patient feels pain.Believe that this is
Local nerve stimulates the result of overall lower degree around eye socket.Before obturator is extruded, in the event for needing to soften it
In, heating body of gland is also advantageous.
Another embodiment of the invention is shown in Figure 11 A into 11E, and wherein therapeutic device is incorporated into goggles sample dress
In putting, the latter is " hydro-oculator " in this paper term, overhead makes treatment mechanical device at eyelid to tie up
Device, generally pointed out 700.Hydro-oculator 700 includes the flexibility with the headband 710 (it can be elastic) for connecting each end
Framework 705.Molding outer cover 720 with the angled leg 725 being adapted to press against when using apparatus above cheekbone is connected to frame
The bottom of frame 705.In addition, herein referred to as the expandable fluid of pouch 730 or the impermeable container of gas be placed on by
In the chamber that space between outer cover and palpebra inferior limits.Pumping mechanism is provided, promotes fluid or gas (to be herein collectively referred to as
" medium " (not shown)) it is moved into and flows out respective pouch 730.According to the present invention, patient should be by hydo-oclulator
700 are placed on his or her head, so that the leg 725 of molding outer cover 730 is rested on cheekbone, such as preferably in Figure 11 C-11E
As shown.Adjusted heating medium is pumped into pouch 730, causes its demi-inflation, to apply to eyelid from every square
The pressure of inch 0 to 50 pound (50psi).By the pouch of the medium (group water solution is preferable) containing heating be placed on Meibomian gland it
On eyelid on period (being up to 30 minutes) for persistently preselecting, to soften obturator.Desirably, directly to contact eyelid
Form place thermal source, Meibomian gland is thus transferred thermal energy to, on the contrary, in the prior art, making to be limited before eyes are opened
The space heating of system, herein temperature can be passed to eyeball structure, such as cause the crystalline lens of the possibility of Cataractogenesis.Its
Afterwards, pouch is slowly expanded to the maximum of pre-selection, so that the power put on body of gland increases to top, or the hole of body of gland from bottom
Mouth end, so, extrusion obturator is acted with " milking " type therefrom.The frequency that can be preselected with 0 to 5 hertz (0-5Hz), which applies, squeezes
Milk sample extruding force and the period for continuing pre-selection, typically no more than 30 minutes.In addition, can be by medium " pulsation " i.e. as milking sample moves
Enter and remove pouch, further to promote obturator to be extruded from body of gland.Also by providing external force to pouch and power can be passed through into stream
Body transmits into body of gland and realizes pulsation.The frequency that can be preselected with 0 to 100 hertz (0-100Hz) applies the time that pulsation persistently preselects
Section, typically no more than 30 minutes.Chemical agent or medicine can be inserted Meibomian gland to help to soften obturator, and the above can be reused
Any Smoking regime referred to is to help to exclude obturator.
Chemical agent or compound can be used to clean gland margin in another embodiment of the invention, to be gone from gland orifice
Except cell or cell pellets are made to come off.It can be used similar to the probe shown in Fig. 5, the difference is that external rotary drum or roller will pass
Pass chemical agent and by using the pumping function applied by outer cover to extract chemical agent used out from gland margin and cellular material mixes
Compound.Similarly, heating discussed above and vibration characteristics be may also comprise.
Another embodiment of the invention, vibration and/or heat energy can be transmitted to obturator P without contacting body of gland.It is a kind of
The potential energy is the laser provided by titanium-sapphire, argon, krypton, RP energy or microwave energy.Obstructions thing will pass through the above
The instrument of description is completed.
Another embodiment of the invention, using the purposes of chemical agent or medicine to open or expand body of gland and body of gland
Hole.Wherein obturator is expressed and recovered the normal secretions of body of gland.Or, it should using chemical agent or medicine so that resistance
Plug thing softens or division, so, uses obturator as device as defined above or its combination extrusion.Also can combine with device
It is used to post-process using chemical agent or medicine.Once body of gland is opened, then chemical agent or medicine can be used to improve just
Often produce or secrete, to maintain body of gland to be in non-blocking state.
The expansion of meibomian gland channel and hole can also be used so that obturator is loosened from gland walls or dissociates to get off.Can passing through
The means of, pharmacology or machinery realize expansion.
Also can combine with other forms discussed above using the stimulation to Meibomian gland, so that obturator is loosened or is broken.
As mentioned herein above, the present invention is described in detail in the combined figure relevant with the Meibomian gland of eye.Reader will
It is noted that the main contents of the present invention can be applied to identical effect to other bodies of gland of human body, and potential it has been applied to
The domesticated farm animals of value are to treat a variety of diseases.
Claims (25)
1. the apparatus for treating xerophthalmia, it includes：
The light energy source that can be positioned on the outside of patient's eyelid, the light energy source are configured to deliver on the outside of patient's eyelid
Light energy is to eyelid；With
Controller, it is configured to control light energy source, keeps being enough to soften in eyelid to eyelid delivering light energy
A period of time of the obturator of at least one Meibomian gland.
2. the apparatus of claim 1, wherein the light energy source is further configured to especially at least one Meibomian gland
Obturator delivers light energy, without being physically contacted with least one Meibomian gland.
3. the apparatus of claim 1, wherein the light energy source is further configured to especially to positioned at least one Meibomian gland
Meibomian gland channel in obturator delivering light energy.
4. the apparatus of claim 1, further comprising power bringing device, it is configured to apply adjusted directive force that will block
Thing is extruded from least one Meibomian gland.
5. the apparatus of claim 1, wherein the light energy source is further configured to deliver light energy to eyelid, and at least
One Meibomian gland, which conductively applies, is enough the heat for melting obturator.
6. the apparatus of claim 1, wherein the light energy delivered by light energy source is following one or more：Laser energy
Amount, infrared light, RF energy and microwave energy.
7. for handle with meibomian gland channel and meibomian gland channel top meibomian gland orifices Meibomian gland apparatus, including：
Heater, it is configured to apply adjusted heat to the eyelid containing at least one Meibomian gland, is enough to be melted in reach
At least one obturator at least one Meibomian gland simultaneously makes at least one obturator be in the temperature of melting state；
Controller, it is configured to keep adjusted heat to be enough to melt at least one obturator and makes at least one obturator
A period of time in melting state；With
Pressure applicator, it is configured to contact with eyelid through placing, and applies pressure on the substantial portion of eyelid with by institute
At least one obturator is stated to extrude from least one Meibomian gland.
8. the apparatus of claim 7, wherein at least one obturator is located in meibomian gland channel, and
Heater is configured as applying adjusted heat and is enough to melt at least one obstruction in meibomian gland channel to reach
The temperature of thing；
At least one obturator that controller is configured as keeping adjusted heat to be enough to make to be located in meibomian gland channel, which is in, to be melted
A period of time of change state；With
Pressure applicator is configured as applying pressure to meibomian gland channel so that at least one obturator is passed through into meibomian gland orifices
Extruded out of meibomian gland channel.
9. the apparatus of claim 7, wherein described a period of time includes about 10-60 minutes.
10. the apparatus of claim 7, wherein the pressure applicator is at least partly to heat.
11. the apparatus of claim 7, wherein the heater is configured as applying adjusted heat, until temperature reaches about
Between 44 and 47 degrees Celsius.
12. the apparatus of claim 7, wherein the pressure applicator is further configured to 3 after terminating in described a period of time
Apply pressure in minute.
13. the apparatus of claim 8, wherein the pressure applicator be further configured to out of meibomian gland channel by one or
The meibomian gland orifices of multiple Meibomian glands, as at least one obturator of thawing of the milking sample extrusion in meibomian gland channel.
14. at least one of the apparatus of claim 7, wherein heater and controller was further configured between the regular hour
Apply every repetition and keep adjusted heat, to keep the liquid from Meibomian gland to flow.
15. the apparatus of claim 14, wherein pressure applicator are further configured to repeat to apply pressure at a certain time interval
Power, to keep the liquid from Meibomian gland to flow.
16. the apparatus of claim 7, wherein pressure applicator are further configured to apply mechanical energy stimulation to eyelid.
17. the apparatus of claim 7, wherein pressure applicator are further configured to extrude eyelid and apply constant pressure to eyelid
Contracting power.
18. the apparatus of claim 7, wherein the pressure applicator is further configured to apply vibratory stimulation to eyelid.
19. the apparatus of claim 7, wherein pressure applicator are further configured to apply pulsating compression power to eyelid.
20. at least one of the apparatus of claim 7, wherein heater and controller is configured as removing application through adjusting from eyelid
The heat of section, to allow pressure applicator to apply pressure to Meibomian gland.
21. the apparatus of claim 7, wherein heater are configured as during pressure is applied to one or more Meibomian glands, to
The meibomian gland channel of one or more Meibomian glands applies adjusted heat.
22. the apparatus of claim 7, wherein heater further comprise heating element heater.
23. the apparatus of claim 22, wherein heater further comprise the heat abstractor with heating element heater coupling, with from heating
Element transmits heat to eyelid.
24. the apparatus of claim 22, wherein heater further comprise with the insulator of heating element heater coupling to reduce heat waste
Lose.
25. the apparatus of claim 24, wherein heater further comprise the backing plate with insulator coupling.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201710219080.3A CN107468415A (en) | 2006-08-21 | 2006-08-21 | For treating the method and apparatus of gland dysfunction |
Applications Claiming Priority (3)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| PCT/US2006/032544 WO2008024100A2 (en) | 2006-08-21 | 2006-08-21 | Method and apparatus for treating gland dysfunction |
| CN2006800561813A CN101547666B (en) | 2006-08-21 | 2006-08-21 | Apparatus for treating gland dysfunction |
| CN201710219080.3A CN107468415A (en) | 2006-08-21 | 2006-08-21 | For treating the method and apparatus of gland dysfunction |
Related Parent Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN2006800561813A Division CN101547666B (en) | 2006-08-21 | 2006-08-21 | Apparatus for treating gland dysfunction |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| CN107468415A true CN107468415A (en) | 2017-12-15 |
Family
ID=39107251
Family Applications (2)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN201710219080.3A Pending CN107468415A (en) | 2006-08-21 | 2006-08-21 | For treating the method and apparatus of gland dysfunction |
| CN2006800561813A Active CN101547666B (en) | 2006-08-21 | 2006-08-21 | Apparatus for treating gland dysfunction |
Family Applications After (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN2006800561813A Active CN101547666B (en) | 2006-08-21 | 2006-08-21 | Apparatus for treating gland dysfunction |
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| Country | Link |
|---|---|
| EP (4) | EP2056753B1 (en) |
| JP (1) | JP5432713B2 (en) |
| CN (2) | CN107468415A (en) |
| WO (1) | WO2008024100A2 (en) |
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| CN109568804A (en) * | 2018-12-13 | 2019-04-05 | 李冠峰 | A kind of chalazion therapeutic equipment |
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- 2006-08-21 CN CN201710219080.3A patent/CN107468415A/en active Pending
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| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN109568804A (en) * | 2018-12-13 | 2019-04-05 | 李冠峰 | A kind of chalazion therapeutic equipment |
| CN109568804B (en) * | 2018-12-13 | 2021-01-01 | 河南省儿童医院郑州儿童医院 | Meibomian gland cyst therapeutic instrument |
Also Published As
| Publication number | Publication date |
|---|---|
| JP2010501245A (en) | 2010-01-21 |
| EP2056753A4 (en) | 2012-12-05 |
| EP2056753A2 (en) | 2009-05-13 |
| EP2053997A1 (en) | 2009-05-06 |
| EP3078358A1 (en) | 2016-10-12 |
| EP3078358B1 (en) | 2021-01-06 |
| JP5432713B2 (en) | 2014-03-05 |
| EP2056753B1 (en) | 2016-06-15 |
| CN101547666A (en) | 2009-09-30 |
| WO2008024100A3 (en) | 2009-04-30 |
| EP2053997A4 (en) | 2011-04-27 |
| EP2056974A4 (en) | 2012-10-03 |
| WO2008024100A2 (en) | 2008-02-28 |
| EP2056974A1 (en) | 2009-05-13 |
| CN101547666B (en) | 2012-06-20 |
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